Overall Satisfaction

Overall Satisfaction
1 Given all the considerations, how satisfied are you with your
consumer directed support program?
How likely would you be to recommend a consumer directed
support program in your county to a friend in a similar situation? .
Very
satisfied
Very
likely
1
3 Has the consumer directed support program met the expectations Exceeded
Neither satisfied
nor dissatisfied Very
dissatisfied
Neither likely
nor unlikely
T
Met
Expectations
Very
unlikely
Failed
Expectations
. R L • • Expectations
that were set for you by your case manager and county social \_y • —-—r—
services department? ( • • • • • • •
%. What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? i
Thinking beyond consumer directed supports to your overall quality of life, on the following pages
please indicate how much you agree or disagree with each statement/ Please complete these, sections
from the perspective of the person with a developmental disability. The person who hasjh^^^
developmental disability should be directly involved in completing this survey as much as pbssible.^*PR
1.
3.
4.
5.
6.
7.
Independence I Mobility / Control / Privacy Agree
Y -
Neither
Disagree
Somewhat Strongly
I can (even if someone helps me because of my disability) get
to where I want to go •
I have control over my daily schedule •
I have privacy to be alone or with people I choose •
a" a a •
a -a •
_ a • a
Only people who are supposed to know my personal
information have access to it
I can set desired outcomes (goals) for myself
•
•
•
or •
•
•
a
•
I can decide about how I spend my money • • • •
I can make decisions that will affect my future a • ar • •
I am satisfied with my current level of independence • • •